Diarrhoea & constipation

Diarrhoea

Diarrhoea is increase in frequency or decrease in consistency (liquid or semisolid) of stool
Diarrhoea can be acute (less than 28 dasy) or chronic
Acute diarrhea are mostly infectious in origin and are self limiting and are treated by oral and Intravenous fluids, and use of antibiotics and antiparasitic agents in selected cases
Long
standing diarrhoea are caused by diseases of small and large intestine and pancreatic insufficiency

Small intestinal causes of diarrhea

  • Celiac disease
  • Troipcal sprue
  • Giardiaisis and other parasitic infections
  • Whipple disease
  • Small bowel tuberculosis
  • Small bowe Crohn’s disease
  • Chronic variable immunodeficiency and other immune deficiencies
  • Small intestinal bacterial overgrowth

Large bowel causes of diarrhea

  • Ulcerative colitis
  • Crohn’s disease
  • Microscopic colitis
  • Colonic malignancies
  • Lymphoma
  • Radiation colitis
  • Ischemic colitis

Pancreatic disorders

  • Chronic pancreatitis
  • Cystic fibrosis

Other causes include excessive secretion due to various endocrinological causes
Diagnosis requires evaluation of stool, blood tests, endoscopy, colonoscopy and biopsies. Therapy is targeted at specific etiology.

Constipation

Constipation is decrease in frequency of stool (less than one stool in 3 days) or change form normal stool frequency for a particular individual

Common causes of constipation are

  • Slowness of bowel movement
  • Hypothyroidism
  • Diabetes mellitus
  • Hypercalcemia
  • Hypokalemia
  • Side effect of certain medications
  • Obstructing lesion in colon such as large polyp or malignancy
  • Anal fissure

Evaluation requires blood testing, and colonoscopy., and cross sectional imaging and anal manometry

Treatment is targeted at specific etiology

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